Isr Med Assoc J. 2024 May;26(5):278-282.
Long-term support with a HeartMate 3 (HM3) left ventricular assist device (LVAD) has improved outcomes of patients with end-stage heart failure. However, there is a paucity of data on the outcomes of patients who underwent concomitant cardiac surgical procedure (CCSP) during HM3-LVAD implantation.
To assess our single-center experience with patients who underwent CCSP during the implantation of an HM3-LVAD.
From December 2016 until April 2022, 131 adult patients underwent HM3-LVAD implantation. A total of 23 patients underwent CCSP during the HM3-LVAD implantation+CCSP, and 108 underwent only HM3-LVAD implantation (HM3-only).
The median age was 59 ± 11 years (range 54-67), 82% (n=108) were male, and 76% (n=100) were implanted as a bridge-to-transplant. The concomitant procedures performed during the implantation included 8 aortic valve repairs/replacements, 14 tricuspid valve repairs, 4 patent foramen ovales or atrial septal defect closures, and 3 other cardiac procedures. The mean cardiopulmonary bypass time was 113 ± 58 minutes for the HM3-only group and 155 ± 47 minutes for the HM3+CCSP group (P = 0.007). The mortality rates at 30 days, 6 months, and 12 months post-implantation were 2 (9%), 5 (22%), and 6 (26%) respectively for the HM3+CCSP group, and 7 (6%), 18 (17%), and 30 (28%) for the HM3-only group (P = 0.658, 0.554, and 1.000).
Our experience demonstrated no significant difference in the 30-day, 6-month, and 12-month mortality rates for patients who underwent a CCSP during HM3-LVAD implantation compared to patients who did not undergo CCSP during HM3-LVAD implantation.
使用 HeartMate 3（HM3）左心室辅助装置（LVAD）进行长期支持已改善了终末期心力衰竭患者的预后。然而，在 HM3-LVAD 植入期间同时进行心脏手术（CCSP）的患者的结局数据很少。
评估我们在 HM3-LVAD 植入期间行 CCSP 的单中心经验。
2016 年 12 月至 2022 年 4 月，共 131 例成年患者接受了 HM3-LVAD 植入。共有 23 例患者在 HM3-LVAD 植入期间行 CCSP（CCSP 组），108 例患者仅行 HM3-LVAD 植入（HM3 组）。
中位年龄为 59 ± 11 岁（范围 54-67 岁），82%（n=108）为男性，76%（n=100）为桥接移植。植入期间同时进行的手术包括 8 例主动脉瓣修复/置换术、14 例三尖瓣修复术、4 例卵圆孔未闭或房间隔缺损封堵术和 3 例其他心脏手术。HM3 组的体外循环时间为 113 ± 58 分钟，HM3+CCSP 组为 155 ± 47 分钟（P=0.007）。CCSP 组术后 30 天、6 个月和 12 个月的死亡率分别为 2 例（9%）、5 例（22%）和 6 例（26%），HM3 组分别为 7 例（6%）、18 例（17%）和 30 例（28%）（P=0.658、0.554 和 1.000）。
我们的经验表明，在 HM3-LVAD 植入期间行 CCSP 的患者与未行 CCSP 的患者相比，30 天、6 个月和 12 个月的死亡率无显著差异。
